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    Clinical Trial Results:
    A 6-Month, Multicenter, Randomized, Open-label, Parallel-group Study Comparing the Efficacy and Safety of a New Formulation of Insulin Glargine and Lantus® Injected in the Morning or Evening in Patients with Type 1 Diabetes Mellitus with a 6-month Safety Extension Period

    Summary
    EudraCT number
    2012-001524-35
    Trial protocol
    DK   SE   FI   CZ   LV   HU   NL   EE  
    Global end of trial date
    14 Mar 2014

    Results information
    Results version number
    v1(current)
    This version publication date
    01 Apr 2016
    First version publication date
    14 Jun 2015
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    EFC12456
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01683266
    WHO universal trial number (UTN)
    U1111-1128-5517
    Sponsors
    Sponsor organisation name
    Sanofi aventis recherche & développement
    Sponsor organisation address
    1 avenue Pierre Brossolette, Chilly-Mazarin, France, 91380
    Public contact
    Trial Transparency Team, Sanofi aventis recherche & développement, Contact-US@sanofi.com
    Scientific contact
    Trial Transparency Team, Sanofi aventis recherche & développement, Contact-US@sanofi.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    02 Jul 2014
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    14 Mar 2014
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To compare the efficacy of a new formulation of insulin glargine (HOE901-U300) and Lantus (overall, regardless the injection time) in terms of change of HbA1c from baseline to endpoint (scheduled Month 6) in subjects with type 1 diabetes mellitus.
    Protection of trial subjects
    Subjects were fully informed of all pertinent aspects of the clinical trial as well as the possibility to discontinue at any time in language and terms appropriate for the subject and considering the local culture. During the course of the trial, subjects were provided with individual subject cards indicating the nature of the trial the subject is participating, contact details and any information needed in the event of a medical emergency. Collected personal data and human biological samples were processed in compliance with the Sanofi-Aventis Group Personal Data Protection Charter ensuring that the Group abides by the laws governing personal data protection in force in all countries in which it operates.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    12 Sep 2012
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 17
    Country: Number of subjects enrolled
    Sweden: 6
    Country: Number of subjects enrolled
    Czech Republic: 2
    Country: Number of subjects enrolled
    Denmark: 26
    Country: Number of subjects enrolled
    Estonia: 24
    Country: Number of subjects enrolled
    Finland: 17
    Country: Number of subjects enrolled
    Hungary: 14
    Country: Number of subjects enrolled
    Latvia: 16
    Country: Number of subjects enrolled
    Canada: 22
    Country: Number of subjects enrolled
    Japan: 46
    Country: Number of subjects enrolled
    Romania: 29
    Country: Number of subjects enrolled
    United States: 330
    Worldwide total number of subjects
    549
    EEA total number of subjects
    151
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    494
    From 65 to 84 years
    54
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A total of 846 subjects were screened, of whom 297 subjects were screen failure and 549 subjects were randomized.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    HOE901-U300
    Arm description
    HOE901-U300 for 12 months on top of mealtime insulin analogue.
    Arm type
    Experimental

    Investigational medicinal product name
    Insulin glargine - new formulation
    Investigational medicinal product code
    HOE901-U300
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled pen
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    HOE901-U300 (new insulin glargine 300 units per milliliter [U/mL]) once daily in morning or evening. Dose titration seeking fasting plasma glucose 4.4-5.6 millimole per liter (mmol/L) (80 - 100 milligram per deciliter [mg/dL]).

    Arm title
    Lantus
    Arm description
    Lantus for 12 months on top of mealtime insulin analogue.
    Arm type
    Active comparator

    Investigational medicinal product name
    Insulin glargine
    Investigational medicinal product code
    HOE901-U100
    Other name
    Lantus
    Pharmaceutical forms
    Solution for injection in pre-filled pen
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Lantus (HOE901-U100, insulin glargine 100 U/mL) once daily in morning or evening. Dose titration seeking fasting plasma glucose 4.4-5.6 mmol/L (80 - 100 mg/dL).

    Number of subjects in period 1
    HOE901-U300 Lantus
    Started
    274
    275
    Modified Intent-to-Treat Population
    273
    273
    Completed
    219
    225
    Not completed
    55
    50
         Adverse Event
    5
    4
         Perceived Lack of Efficacy
    1
    1
         Selection Criterion/Protocol Violation
    7
    5
         Serious Adverse Event of Hypoglycemia
    -
    1
         Protocol Violation
    13
    6
         Nonserious Hypoglycemia
    -
    3
         Personal Reason
    17
    25
         Lost to follow-up
    5
    -
         Possibly Hypoglycemia
    1
    -
         Site Closure/Site Withdrawal
    1
    3
         Lack of efficacy
    5
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    HOE901-U300
    Reporting group description
    HOE901-U300 for 12 months on top of mealtime insulin analogue.

    Reporting group title
    Lantus
    Reporting group description
    Lantus for 12 months on top of mealtime insulin analogue.

    Reporting group values
    HOE901-U300 Lantus Total
    Number of subjects
    274 275 549
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    46.4 ( 13.9 ) 48.2 ( 13.4 ) -
    Gender categorical
    Units: Subjects
        Female
    125 111 236
        Male
    149 164 313
    Glycated Hemoglobin (HbA1c)
    Units: Subjects
        Less Than (<) 8%
    105 105 210
        Greater Than or Equal to (>=) 8%
    169 170 339
    Body Mass Index (BMI)
    Units: kilogram per square meter (kg/m^2)
        arithmetic mean (standard deviation)
    27.6 ( 5.5 ) 27.6 ( 4.7 ) -
    Duration of Diabetes
    Number of subjects analyzed for this baseline characteristics = 274 and 272 for each reporting group, respectively.
    Units: years
        arithmetic mean (standard deviation)
    20.5 ( 12.7 ) 21.4 ( 13.1 ) -
    Basal Insulin Daily Dose
    Number of subjects analyzed for this baseline characteristics = 201 and 210 for each reporting group, respectively.
    Units: units per kilogram (U/kg)
        arithmetic mean (standard deviation)
    0.381 ( 0.173 ) 0.372 ( 0.152 ) -
    Total Insulin Daily Dose
    Number of subjects analyzed for this baseline characteristics = 195 and 198 for each reporting group, respectively.
    Units: U/kg
        arithmetic mean (standard deviation)
    0.714 ( 0.278 ) 0.724 ( 0.245 ) -

    End points

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    End points reporting groups
    Reporting group title
    HOE901-U300
    Reporting group description
    HOE901-U300 for 12 months on top of mealtime insulin analogue.

    Reporting group title
    Lantus
    Reporting group description
    Lantus for 12 months on top of mealtime insulin analogue.

    Primary: Change In HbA1c From Baseline to Month 6 Endpoint

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    End point title
    Change In HbA1c From Baseline to Month 6 Endpoint
    End point description
    Modified Intent-to-Treat (mITT) population: all randomized subjects who received at least (>=)1 dose, had baseline and >=1 post-baseline assessment of any efficacy variable, irrespective of compliance. Number of subjects analyzed = subjects with baseline and Month 6 HbA1c assessment.
    End point type
    Primary
    End point timeframe
    Baseline, Month 6
    End point values
    HOE901-U300 Lantus
    Number of subjects analysed
    225
    229
    Units: percentage of hemoglobin
        least squares mean (standard error)
    -0.4 ( 0.051 )
    -0.44 ( 0.051 )
    Statistical analysis title
    HOE901-U300 vs. Lantus
    Statistical analysis description
    Analysis was performed using mixed model for repeated measurements (MMRM) with treatment groups, strata of screening HbA1c (<8.0, >=8.0%), geographical region (Non-Japan; Japan), visit and visit-by-treatment groups interaction as fixed categorical effects; baseline HbA1c and baseline HbA1c-by-visit interaction as continuous fixed covariates.
    Comparison groups
    HOE901-U300 v Lantus
    Number of subjects included in analysis
    454
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority [1]
    Method
    Parameter type
    Least Squares (LS) Mean difference
    Point estimate
    0.04
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.098
         upper limit
    0.185
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.072
    Notes
    [1] - Stepwise closed testing approach was used to assess non-inferiority and superiority sequentially: 1. Non-inferiority of HOE901-U300 vs Lantus: Upper bound of two-sided 95% confidence interval (CI) of difference between HOE901-U300 and Lantus on mITT population is <0.4%. 2. Superiority (only if non-inferiority has been demonstrated): Upper bound of two-sided 95% CI for difference in mean change in HbA1c from baseline to endpoint between HOE901-U300 and Lantus on mITT population is <0.

    Secondary: Percentage of Subjects With HbA1c <7% at Month 6 Endpoint

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    End point title
    Percentage of Subjects With HbA1c <7% at Month 6 Endpoint
    End point description
    mITT Population.
    End point type
    Secondary
    End point timeframe
    Month 6
    End point values
    HOE901-U300 Lantus
    Number of subjects analysed
    273
    273
    Units: percentage of subjects
        number (not applicable)
    16.8
    15
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With HbA1c Less Than or Equal to 6.5% at Month 6 Endpoint

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    End point title
    Percentage of Subjects With HbA1c Less Than or Equal to 6.5% at Month 6 Endpoint
    End point description
    mITT Population.
    End point type
    Secondary
    End point timeframe
    Month 6
    End point values
    HOE901-U300 Lantus
    Number of subjects analysed
    273
    273
    Units: percentage of subjects
        number (not applicable)
    8.1
    5.5
    No statistical analyses for this end point

    Secondary: Change In Average Pre-Injection Self-Monitored Plasma Glucose (SMPG) From Baseline Month 6 Endpoint

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    End point title
    Change In Average Pre-Injection Self-Monitored Plasma Glucose (SMPG) From Baseline Month 6 Endpoint
    End point description
    Pre-injection SMPG was measured within 30 minutes prior to the injection of the study drug. Average was assessed by the mean of at least 3 SMPG calculated over the 7 days preceding the assessment visit. mITT population. Number of subjects analyzed = subjects with baseline and Month 6 pre-injection SMPG assessment.
    End point type
    Secondary
    End point timeframe
    Baseline, Month 6
    End point values
    HOE901-U300 Lantus
    Number of subjects analysed
    117
    105
    Units: millimole per liter (mmol/L)
        least squares mean (standard error)
    -1.16 ( 0.223 )
    -0.82 ( 0.233 )
    Statistical analysis title
    HOE901-U300 vs. Lantus
    Statistical analysis description
    Change in pre-injection SMPG was analyzed using MMRM model with treatment groups, strata of screening HbA1c (<8.0, >=8.0%), geographical region (Non-Japan; Japan), visit and visit-by-treatment groups interaction as fixed categorical effects; pre-injection SMPG value and pre-injection SMPG value-by-visit interaction as continuous fixed covariates.
    Comparison groups
    HOE901-U300 v Lantus
    Number of subjects included in analysis
    222
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    LS Mean difference
    Point estimate
    -0.35
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.982
         upper limit
    0.287
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.322

    Secondary: Change in Variability of Pre-injection SMPG From Baseline to Month 6 Endpoint

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    End point title
    Change in Variability of Pre-injection SMPG From Baseline to Month 6 Endpoint
    End point description
    Pre-injection SMPG was measured within 30 minutes prior to the injection of the study drug. Variability was assessed by the mean of coefficient of variation calculated as 100 multiplied by (standard deviation/mean) over at least 3 SMPG measured during the 7 days preceding the assessment visit. mITT population. Number of subjects analyzed = subjects with baseline and Month 6 pre-injection SMPG assessment.
    End point type
    Secondary
    End point timeframe
    Baseline, Month 6
    End point values
    HOE901-U300 Lantus
    Number of subjects analysed
    117
    105
    Units: percentage of mean
        least squares mean (standard error)
    -3.03 ( 1.573 )
    -1.76 ( 1.651 )
    No statistical analyses for this end point

    Secondary: Change in Fasting Plasma Glucose From Baseline to Month 6 Endpoint

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    End point title
    Change in Fasting Plasma Glucose From Baseline to Month 6 Endpoint
    End point description
    mITT Population. Number of subjects analyzed = subjects with baseline and Month 6 FPG assessment.
    End point type
    Secondary
    End point timeframe
    Baseline, Month 6
    End point values
    HOE901-U300 Lantus
    Number of subjects analysed
    213
    216
    Units: mmol/L
        least squares mean (standard error)
    -0.95 ( 0.263 )
    -1.14 ( 0.26 )
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With Fasting Plasma Glucose (FPG) <5.6 mmol/L (100 mg/dL) At Month 6

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    End point title
    Percentage of Subjects With Fasting Plasma Glucose (FPG) <5.6 mmol/L (100 mg/dL) At Month 6
    End point description
    mITT Population.
    End point type
    Secondary
    End point timeframe
    Month 6
    End point values
    HOE901-U300 Lantus
    Number of subjects analysed
    273
    273
    Units: percentage of subjects
        number (not applicable)
    9.9
    12.8
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With FPG <7.2 mmol/L (130 mg/dL) at Month 6 Endpoint

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    End point title
    Percentage of Subjects With FPG <7.2 mmol/L (130 mg/dL) at Month 6 Endpoint
    End point description
    mITT Population. Number of subjects analyzed = subjects with baseline and Month 6 FPG assessment.
    End point type
    Secondary
    End point timeframe
    Month 6
    End point values
    HOE901-U300 Lantus
    Number of subjects analysed
    273
    273
    Units: percentage of subjects
        number (not applicable)
    25.3
    25.6
    No statistical analyses for this end point

    Secondary: Change in 8-Point SMPG Profiles Per Time Point From Baseline to Month 6 Endpoint

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    End point title
    Change in 8-Point SMPG Profiles Per Time Point From Baseline to Month 6 Endpoint
    End point description
    Change in each time-point of 8-point SMPG profile: 03:00 hours (clock time) at night; before and 2 hours after breakfast; before and 2 hours after lunch; before and 2 hours after dinner; and at bedtime. mITT Population. Here, n = subjects with Baseline and Month 6 8-point SMPG assessment separately for each analysed time point.
    End point type
    Secondary
    End point timeframe
    Baseline, Month 6
    End point values
    HOE901-U300 Lantus
    Number of subjects analysed
    273
    273
    Units: mmol/L
    arithmetic mean (standard deviation)
        03:00 at Night (n= 156, 159)
    -0.47 ( 4.56 )
    -0.67 ( 4.98 )
        Pre-Breakfast (n= 166, 167)
    -0.86 ( 5.3 )
    -0.07 ( 5.2 )
        2 Hours After Breakfast (n= 152, 156)
    -0.62 ( 4.75 )
    -1.18 ( 5.66 )
        Pre-Lunch (n= 166, 166)
    -0.95 ( 4.53 )
    -0.93 ( 4.76 )
        2 Hours After Lunch (n= 163,163)
    -0.13 ( 5.2 )
    -1.43 ( 5.37 )
        Pre-Dinner (n= 165,166)
    -0.56 ( 6 )
    -1.74 ( 5.28 )
        2 Hours After Dinner (n= 154,152)
    -0.93 ( 5.27 )
    -1.19 ( 5.51 )
        Bedtime (n= 141,146)
    -0.8 ( 5.39 )
    -1.91 ( 5.1 )
    No statistical analyses for this end point

    Secondary: Change in Daily Average Total Insulin Dose From Baseline to Month 6 Endpoint

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    End point title
    Change in Daily Average Total Insulin Dose From Baseline to Month 6 Endpoint
    End point description
    mITT Population. Number of subjects analyzed = subjects with Baseline and Month 6 daily average total insulin dose assessment.
    End point type
    Secondary
    End point timeframe
    Baseline, Month 6
    End point values
    HOE901-U300 Lantus
    Number of subjects analysed
    173
    158
    Units: U/kg
        arithmetic mean (standard deviation)
    0.19 ( 0.22 )
    0.1 ( 0.16 )
    No statistical analyses for this end point

    Secondary: Change in Total Treatment Satisfaction Score Using The Diabetes Treatment Satisfaction Questionnaire (DTSQs) From Baseline to Month 6 Endpoint

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    End point title
    Change in Total Treatment Satisfaction Score Using The Diabetes Treatment Satisfaction Questionnaire (DTSQs) From Baseline to Month 6 Endpoint
    End point description
    DTSQ is a validated measure to assess how satisfied subjects with diabetes are with their treatment and how they perceive hyper- and hypoglycemia. It consists of 8 questions which are answered on a Likert scale from 0 to 6. DTSQ treatment satisfaction score is the sum of question 1 and 4-8 scores and ranges between 0 and 36, where higher scores indicate more treatment satisfaction. mITT Population. Number of subjects analyzed = subjects with Baseline and Month 6 DTSQ assessment.
    End point type
    Secondary
    End point timeframe
    Baseline, Month 6
    End point values
    HOE901-U300 Lantus
    Number of subjects analysed
    212
    206
    Units: units on a scale
        least squares mean (standard error)
    1 ( 0.331 )
    1.41 ( 0.334 )
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With Hypoglycemia (All and Nocturnal) Events From Baseline to Month 12

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    End point title
    Percentage of Subjects With Hypoglycemia (All and Nocturnal) Events From Baseline to Month 12
    End point description
    Hypoglycaemia included: Severe (required assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions); Documented symptomatic (typical symptoms of hypoglycaemia were accompanied by plasma glucose =<3.9 mmol/L); Asymptomatic (not accompanied by typical symptoms of hypoglycaemia but with plasma glucose =<3.9 mmol/L); Probable symptomatic (symptoms of hypoglycaemia were not accompanied by a plasma glucose determination, but was presumably caused by plasma glucose =<3.9 mmol/L); and Relative (subject reported any of the typical symptoms of hypoglycaemia, and interpreted the symptoms as indicative of hypoglycaemia, but with plasma glucose >3.9 mmol/L). Safety population: all subjects randomized and treated, regardless of amount of treatment administered. In event of subjects having received treatments different from those assigned according to the randomization schedule, safety analyses were conducted according to treatment received.
    End point type
    Secondary
    End point timeframe
    Up to Month 12
    End point values
    HOE901-U300 Lantus
    Number of subjects analysed
    274
    275
    Units: percentage of subjects
    number (not applicable)
        Any Hypoglycemia Event: All Hypoglycemia
    95.3
    94.9
        Severe Hypoglycemia: All Hypoglycemia
    9.1
    11.3
        Documented Symptomatic: All Hypoglycemia
    87.6
    86.5
        Asymptomatic: All Hypoglycemia
    76.6
    81.5
        Probable Symptomatic: All Hypoglycemia
    11.3
    15.3
        Relative: All Hypoglycemia
    14.6
    9.5
        Severe and/or Confirmed: All Hypoglycemia
    94.9
    94.5
        Any Hypoglycemia Event: Nocturnal Hypoglycemia
    73.4
    74.9
        Severe Hypoglycemia: Nocturnal Hypoglycemia
    3.3
    3.3
        Documented Symptomatic: Nocturnal Hypoglycemia
    64.2
    63.3
        Asymptomatic: Nocturnal Hypoglycemia
    35
    38.9
        Probable Symptomatic: Nocturnal Hypoglycemia
    5.1
    6.5
        Relative: Nocturnal Hypoglycemia
    4
    5.5
        Severe and/or Confirmed: Nocturnal Hypoglycemia
    72.6
    74.5
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All Adverse Events (AE) were collected from signature of informed consent form up to study completion regardless of seriousness or relationship to study drug.
    Adverse event reporting additional description
    Reported adverse events and deaths are treatment-emergent that is AEs that developed/worsened and death that occurred during on-treatment period (as the time from first injection of IMP up to 2 days after the last injection of IMP). Analysis was done on safety population.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    Lantus
    Reporting group description
    Lantus SC injection once daily in morning or evening for 12 months on top of mealtime insulin.

    Reporting group title
    HOE901-U300
    Reporting group description
    HOE901-U300 SC injection once daily in morning or evening for 12 months on top of mealtime insulin.

    Serious adverse events
    Lantus HOE901-U300
    Total subjects affected by serious adverse events
         subjects affected / exposed
    26 / 275 (9.45%)
    27 / 274 (9.85%)
         number of deaths (all causes)
    0
    1
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Malignant Melanoma
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Femoral Artery Occlusion
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypertension
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Non-Cardiac Chest Pain
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Immune system disorders
    Hypersensitivity
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Accidental Overdose
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Brain Contusion
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Comminuted Fracture
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Joint Dislocation
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Open Fracture
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Overdose
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Patella Fracture
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pelvic Fracture
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rib Fracture
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Road Traffic Accident
         subjects affected / exposed
    2 / 275 (0.73%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal Compression Fracture
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subdural Haematoma
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tendon Rupture
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thoracic Vertebral Fracture
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Angina Pectoris
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrioventricular Block Complete
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Coronary Artery Disease
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Nervous system disorders
    Aphasia
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Convulsion
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diabetic Neuropathy
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoglycaemic Seizure
         subjects affected / exposed
    1 / 275 (0.36%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoglycaemic Unconsciousness
         subjects affected / exposed
    1 / 275 (0.36%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Loss Of Consciousness
         subjects affected / exposed
    1 / 275 (0.36%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Ileus
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Diabetic Foot
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urticaria
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Renal Failure Acute
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary Retention
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Dupuytren's Contracture
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chronic Tonsillitis
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Erysipelas
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    H1n1 Influenza
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyelonephritis
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary Tract Infection
         subjects affected / exposed
    1 / 275 (0.36%)
    0 / 274 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viral Infection
         subjects affected / exposed
    0 / 275 (0.00%)
    1 / 274 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Diabetic Ketoacidosis
         subjects affected / exposed
    1 / 275 (0.36%)
    2 / 274 (0.73%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    13 / 275 (4.73%)
    16 / 274 (5.84%)
         occurrences causally related to treatment / all
    10 / 16
    13 / 17
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Lantus HOE901-U300
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    86 / 275 (31.27%)
    113 / 274 (41.24%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    13 / 275 (4.73%)
    17 / 274 (6.20%)
         occurrences all number
    14
    29
    Musculoskeletal and connective tissue disorders
    Back Pain
         subjects affected / exposed
    7 / 275 (2.55%)
    14 / 274 (5.11%)
         occurrences all number
    9
    15
    Infections and infestations
    Influenza
         subjects affected / exposed
    14 / 275 (5.09%)
    16 / 274 (5.84%)
         occurrences all number
    15
    16
    Nasopharyngitis
         subjects affected / exposed
    35 / 275 (12.73%)
    43 / 274 (15.69%)
         occurrences all number
    37
    56
    Sinusitis
         subjects affected / exposed
    11 / 275 (4.00%)
    14 / 274 (5.11%)
         occurrences all number
    11
    20
    Upper Respiratory Tract Infection
         subjects affected / exposed
    26 / 275 (9.45%)
    38 / 274 (13.87%)
         occurrences all number
    39
    49

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    13 Aug 2013
    - Route and method of investigational medicinal product (IMP) administration – clarification of the definition of injection area and injection site within that area. - Timing of IMP injection – clarification of the window for timing of IMP injections. - Adjustment of IMP – clarification of titration beyond 6 to 8 weeks. - Non-investigational medicinal product (NIMP) – emphasis of the need to avoid daytime hypoglycemia, specific guidance on when to begin optimization of the mealtime insulin dose, recording of all doses of mealtime insulin analog. - Review of severe hypoglycemia classification by external Review Board – all hypoglycemia events reported by Investigator as severe and/or reported as serious adverse events (SAEs) were to be independently reviewed by a Severe Hypoglycemia Review Board (SHRB) blinded to treatment arm. This was to ensure consistent use of the severe hypoglycemia classification according to American Diabetes Association definition across the study. Both the Investigators’ classification and the Review Board’s assessment were to be reported. - Screening period – clarification that screening period could be extended from 2 to 3 weeks. - SMPG and change to the scope of data recorded into the electronic case report form upon phone call visits – clarification of documentation of SMPG. Furthermore, in order to reduce burden to subjects and minimize potential for transcription errors, the amount of SMPG data to be collected during phone call visits was reduced to the minimum required for the IMP dose adjustment. However, the remaining SMPG as well as IMP and mealtime insulin dose data of the week prior to the phone call visits recorded by the subject in the diary, were collected at the subsequent on-site visits. - Reporting of SAE and adverse events of special interest (AESI) – clarification of the process of SAE and AESI reporting.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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